| The Downtown Medcenter | |
|
119 Chestnut St Wilmington NC 28401-3940 | |
| (910) 762-5588 | |
| (910) 762-5589 |
| Full Name | The Downtown Medcenter |
|---|---|
| Speciality | Clinic/Center |
| Location | 119 Chestnut St, Wilmington, North Carolina |
| Authorized Official Name and Position | James Patrick Egerer (OWNER) |
| Authorized Official Contact | 9107625588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Downtown Medcenter 119 Chestnut St Wilmington NC 28401-3940 Ph: (910) 762-5588 | The Downtown Medcenter 119 Chestnut St Wilmington NC 28401-3940 Ph: (910) 762-5588 |
| NPI Number | 1093785719 |
|---|---|
| Provider Enumeration Date | 01/25/2006 |
| Last Update Date | 10/19/2012 |
| Medicare PECOS PAC ID | 7719890508 |
|---|---|
| Medicare Enrollment ID | O20031107000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093785719 | NPI | - | NPPES |
| 012V5 | Other | NC | BC/BS OF NC |
| 89012V5 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 69766 (North Carolina) | Primary |
| Provider Name | Henry W Traylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588677736 PECOS PAC ID: 3971539586 Enrollment ID: I20071105000155 |
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